Waging War on HAIs
The awareness of the need to minimize infection in order to optimize patient outcomes is not a new one. In fact, efforts to control infection dates back as far as the late 1800’s.
Healthcare facilities must comply with rigorous standards of quality and safety, and actively seek ways to improve care. Such efforts have lead to improved infection prevention guidelines and “best practices” being adopted that are effective in reducing HAI rates. However, increasing concerns about the public health impact of HAIs, Target Zero campaigns, as well as healthcare reform efforts, mandate the need for heightened vigilance and a proactive plan of action that extends beyond any individual healthcare facility to wage an effective war on HAIs.
The following are the National and State level HAI action plans, and consumer awareness initiatives to further enhance continuing HAI identification and reduction efforts beyond the hospital level. Also see the Links Page for other National and State Organizations with a focus on HAIs.
National Action Plan
The U.S. Department of Health and Human Services (HHS) Action Plan incorporates research, deliberation, and public opinion to identify the key actions needed to achieve and sustain progress in protecting patients from the transmission of infections.
The priorities identified in this plan include:
- progress towards five-year national prevention targets (e.g., 50-70% reduction in bloodstream infections);
- improving use and quality of the metrics and supporting systems needed to assess progress towards meeting the targets; and
- prioritization and broad implementation of current evidence-based prevention recommendations.
State HAI Action Plan
The Alabama HAI Prevention Plan was developed and submitted to the Secretary of HHS in January 2010 as required by all states receiving Preventive Health and Health Services (PHHS) Block Grant funds. The PHHS Block Grant provides all 50 states, the District of Columbia, two American Indian tribes, and eight U.S. territories with funding to address their own unique public health needs and challenges.
The Alabama HAI Plan was modeled on recommendations from the HHS Action Plan to Prevent HAIs. The plan provides a blueprint of HAI reduction activities as funded by the American Recovery and Reinvestment Act (ARRA) stimulus funds, including the coordination and reporting of State HAI prevention efforts (Activity “A”), detection and reporting of HAI data (Activity “B”), target dates for completion of such activities, and the discussion of how to sustain these activities after ARRA stimulus monies expire.
Activity A: Coordination and Reporting of State HAI Prevention Efforts
The purpose of coordinating and reporting state HAI prevention efforts is to develop a HAI State Prevention Plan to coordinate and implement HAI prevention activities, and report on progress towards reductions in two or more HHS Action Plan Targets. The HAI State Prevention Plan was required to be submitted by January 1, 2010. Rules are now being developed by ADPH and the HAI Healthcare Data Council to determine the Alabama Reporting HAI target categories.
Activity B: Detection and Reporting of HAI Data
The purpose of detecting and reporting HAI Data is to develop sustainable State HAI reporting using an acceptable data reporting system, consistent HAI definitions and surveillance methods, and to evaluate data received. Also included in the plan is the status of legislation in the state of Alabama, the Mike Denton Infection Reporting Act, to mandate public reporting of HAI data for prevention initiatives.
Consumers of health care also have a role in the prevention and reduction of HAIs. The Centers for Disease Control and Prevention (CDC) HAI website includes specific ways to combat the following target HAIs:
- Catheter-associated urinary tract infection (CAUTI)
- Surgical site infection (SSI)
- Central line-associated bloodstream infection (CLABI)
- Ventilator-associated pneumonia (VAP)
- Clostridium difficile
- Methicillin-resistant Staphylococcus aureus (MRSA)
According to HHS, simply implementing what we know for prevention can lead to a 70% or more reduction in HAIs.